1. Field of the Invention
This invention relates generally to surgical grasping, retracting and occluding devices having opposing jaws, and more specifically to such devices which are provided with atraumatic inserts which extend in opposing relationship along the jaws.
2. Discussion of the Prior Art
Clamps and clips have been used in surgical procedures to engage and release various body structures such as organs and conduits. Such instruments are commonly referred to by the function that they perform once the organ has been engaged. Thus, the prior art includes graspers which engage the organ, retractors which are used to move the organ to a different location, and occluders which are used to close body conduits. All of these instruments include opposing jaws which are movable relative to each other between a proximate position wherein the organ is engaged, and a spaced position wherein the organ is released.
Where the organ is particularly fragile, these clamping devices have been provided with atraumatic inserts which are mountable on the jaws of the device, and include a compressible elastomeric material which softens the grip on the organ. Unfortunately, these inserts have added greatly to the profile of these devices. Where such devices have been used in open surgery, spacial limitations have easily accommodated the relatively large profile. However, in more confined surgeries, such as laparoscopic procedures, the relatively high profiles have not been tolerable.
One such laparoscopic surgery involves the removal of the gall bladder. When this organ is diseased, use of a grasper or retractor without inserts can result in tearing the organ. This not only releases toxic bile into the abdominal cavity, but also can release gall stones into the pneumoperitoneum. In either case, the procedure is dramatically complicated simply because soft jaw inserts producing a high clamp profile which could not be used in this type of surgery.
The high clamp profiles have resulted not only from the configuration of the inserts, but also from the structure relied on for attaching these inserts to the associated jaws. In the latter regard, holes have been drilled into the supporting surface of the associated jaw. Oversized projections on the insert have been forced into these holes to maintain the insert and jaw in a fixed relationship. Unfortunately, drilling a hole into the supporting surface of the jaw has substantially weakened the jaw particularly in the direction of closure which extends between the jaws. To overcome this weakness, an additional depth of material has been required along the plane of closure to add structural integrity to the jaws.
The inserts of the prior art have included an insert base which generally extends along the direction of closure away from the supporting surface. Side walls of the insert base have extended toward the opposing jaw to further increase the profile of the clamping device.
A third element adding to this profile is the depth of the elastomeric material which is relied on for the atraumatic feature of the insert. This depth of elastomeric material has been accommodated almost totally in the space extending between the insert base and the second jaw.
Each of these structural limitations has added to the profile of the clamping devices of the past. Where these features have appeared in combination, atraumatic clamping has only been possible in open surgeries.